Jill D. Kuzma, M.A., CCC-SLP Speech-Language Pathologist

Facing the Frontal Lobe: Strategies to Support Executive Function Skills
Jill D. Kuzma, M.A., CCC-SLP Speech-Language Pathologist Social/Emotional Teacher August 2012

August 2012

Do you have Executive Function skills?
How did you get here today on time? Your family wants to eat dinner at 6 and you’re the cook: How do you get the food on the table in time? Someone cuts you off in a traffic lane (and you have your child in the car): What keeps you from yelling “#**#!#%#!!”? The students in the next classroom are playing a loud game while you writing an IEP, but you don’t hear it. Why? You accidentally bump into someone and apologize. Why? August 2012

Questions to consider…
What are executive function skills and how do selected executive function processes affect school success? How can educators begin to understand and informally assess students’ executive function processes? How can teachers address the needs of students with executive function weaknesses to both accommodate and teach necessary lacking skills? August 2012

Overview of the Day… Define Executive Function Skills:
August 2012 Overview of the Day… Define Executive Function Skills: Emotional and Cognitive Aspects Jill’s Interpretation of EF for “school-folk” – 5 Areas Brain Food How do EF skills impact our students? Assessing Executive Function Skills (as relevant to the school-setting and the role of educators) Formal Rating Scales Informal Interviews & guidelines for Observations Supporting Executive Function Needs in Learners Emotional Control needs Focus and Attention needs Planning needs Working Memory needs Organization needs Program support and structure ideas August 2012

What are Executive Function Skills?
August 2012

Defining EF Conscious control of what we think and do
Enables self-regulation of one’s own social actions and display of emotions Coordinates goal-setting with the planning required to accomplish the goal or task (organizing, sequence, self-monitoring, evaluating) Control of Attention and Focus skills Ability to think/act in a flexible manner with tolerance for frustration. August 2012

Emotional Aspects of EF
Impulse control Use of “Social Filter” Self-monitoring social behaviors Tolerance Delay of immediate gratification Establishing attention & filtering attention Emotional Aspects of EF “Self-Regulation” Organizing time, materials, projects Prioritizing Attention shifting Risk-assessment Informed decision making Use of Verbal & Non-Verbal Working Memory Cognitive Aspects of EF “MetaCognition” August 2012

Focus & Attention Skills
Emotional Control Impulse control Adaptability Cognitive Flexibility Inhibition & Initiation Working Memory Verbal working memory Non-verbal working memory Planning Skills Self-checking/monitoring Prioritizing, planning increments Problem Solving Organization Materials, space (desks-lockers) Ideas Time Management Focus & Attention Skills Selecting the attention target/main topic Ignoring Distractions Activating & initiating work Task Persistence Executive Function Categories August 2012

Lacking EF Skills Looks like….
Impulsive actions and decision-making May appear “irresponsible” compared to peers Lack of a “social filter” Difficulty being flexible and cognitively shifting Risk-taking and compulsive behaviors in teens Child may know the rules & be able to repeat them, but not be able to put them into practice Forgetting, losing materials & assignments Leaving things to the last minute August 2012

Lacking EF Skills Looks like….
Difficulty taking notes Difficulty summarizing orally or in writing Difficulty making the shift between using a graphic organizer and actually starting the writing task. Difficulty shifting between math operations Loses/forgets materials when transporting between home & school Student constantly negotiates to avoid tasks, for breaks or reinforcers August 2012

Social & Self-Esteem Executive Function deficits can result in….
Difficulty waiting for turns Appear overly talkative Appear overly judgmental – or insensitive to peers May appear one step behind peers Black and white thinking Trouble with team sports where there is cooperative organization requiring impulse control to remain in one role Limited frustration tolerance with other kids Confusion, anxiety or depression from social failures August 2012

EF Skills & the BRAIN Mid-Brain Limbic system- Cortex - Brainstem-
Automatic behaviors, Emotions, Memory Cortex - Conscious thought Brainstem- Survival Cerebellum Coordinated movements, balance and voluntary movements August 2012

EF Skills & the BRAIN Frontal Lobe – Pre-Frontal Cortex (PFC)
The PFC gives us the potential to consider and voluntarily control our thinking, emotional responses, and behavior. Amygdala - a switching station in the limbic system that determines if information will go to the PFC or to the lower brain that "reacts" but does not "learn.” – Stress (frustration, boredom) will increase metabolic activity for lower brain to “react” – fight/flight/freeze, which translates to zoning out, acting out, etc. August 2012

EF Skills & the BRAIN RAS – Reticular Activating System – an involuntary attention filter to promote and sustain attention Thalamus – processes and relays all incoming sensory information, also has a role in regulating sleep and wakefulness Hippocampus – role in learning associated with emotions, and the formation of new memories August 2012

EF Skills & the BRAIN Frontal Lobe connections are the last to develop – brain’s neuroplasticity – pruning & myelinating (mostly between 8-18) Learning – application and meaningful, relevant synthesizing activities results in committing skills to long term memory (myelinating) Brain dissolves isolated small neural networks of "unincorporated" facts and procedures that are rarely activated beyond drills and tests (pruning) August 2012

Our friend, Phineas Gage
1845 Railroad Construction Foreman August 2012

Categories of EF Skills
Emotion Control Skills Focus/Attention Skills Organization Skills Working Memory Skills Planning Skills August 2012

Emotional Control Skills
Self-Regulation is a balance between INHIBITION and INITIATION “impulsive”, “can’t stop when asked” Behavioral Inhibition “daydreams”, “off-topic” Cognitive Inhibition Regulate affect & reactions Self-Monitoring Social Perspective Taking Barkley, 2000 August 2012

Focus/Attention Skills
Activate & Initiate Attention Arouse the effort and motivation to attend Target the prominent stimuli to attend to Sustain Attention & Filter Maintain alertness Filter out extra stimuli that competes for attention Resist distractions Shift Attention Shift too quickly - “distractible” Shift too slowly – “inattentive” Can’t Shift – “perseverative-rigid” August 2012

Organization Skills Homework materials Tracking Assignments
Ideas Written Language assignments Brainstorming Schedule Calendar checking Using a planner Time Feel the “sweep of time” Prioritizing August 2012

Memory We direct our attention to stimuli: SHORT TERM MEMORY
If we decide we need this information… Verbal (Auditory) WORKING MEMORY Non-Verbal (Visual) LEARNING (Long-Term Memory) RETRIEVAL August 2012

Working Memory Planning largely involves WORKING MEMORY: this is your “desktop” or “sketchpad” – hold information in your memory long enough to do something with it. Non-Verbal Working Memory Enables: sense of time, see mental visual representations, ability to see in hindsight & have foresight Verbal Working Memory Enables: ability to hold language “online” while talking, “self-talk”, self-questioning August 2012

Planning Skills Use PLANNING skills for problem solving and acting with intention: Imagine an end product – what you want, or need to get done Idea or Task Create a Plan with materials, time management, sequence Sequential PLAN Execute the plan (with self-monitoring) Execution Evaluate the plan and end product – is this what I imagined? Evaluate Design a course of action…. August 2012

Development of EF Skills
References: 1) Zelazo, P. et al. (2010) - 6 Part Series on Executive Function 2) Best, J. R., & Miller, P. H. (2010). A Developmental Perspective on Executive Function. Child Development, 81(6), 3) Dawson & Guare (2010). Executive Skills in Children and Adolescents: A Practical Guide to Assessment and Intervention. Guilford Press - August 2012

Birth -3 years Move from infants who are reactive to everything in environment and easily distracted to a willful toddler with a goal in mind EF begins to develop toward the end of the 1st year when “Object Permanence” develops “Anticipatory Looking” and looking away from aversive stimuli are precursors to developing emotional control skills 3-yr olds start to keep rules in mind & use them to guide their behavior. Can start to chose between 2 rules and guidelines August 2012

3-6 year olds should be able to….
Preschoolers can begin to think about the past and plan for the future Still difficult to have conscious control over emotions, despite knowing the “right thing” to do Difficulty “choosing” to delay gratification or reward Preschoolers start to be able to inhibit the less desirable choice Follow 2-3 step directions August 2012

Attention becomes volitional Able to handle delayed gratification Develop beginning stages of problem solving (identification, search for a cause, brainstorm solutions) – but frequently requires adult guidance for solving and preventing problems Completed development of “theory of mind” – perspective taking skills Working memory significantly developing to hold up to 5-7 pieces of information Can plan/sequence chores taking minutes Shift mental sets/shift attention between multiple tasks (Lucianna, 2003) August 2012

Growth in verbal working memory skills Able to select, shift and maintain attention sets Able to reflect upon “hindsight” and developing foresight Should be able to keep track of belongings away from home/school Self-regulate (behave when teacher out of the room, refrain from temper tantrum, refrain from rude comments) Reliably transfer materials to/from school Keep track of scheduled activities outside of school Save money for a desired object, plan ways to earn money August 2012

Help out with chores lasting minutes Use a system taught to them for organizing assignments and homework. Follow a complex school schedule with changing teachers and classrooms Reliably estimate the amount of time it will take to complete homework, chores, etc. Inhibit rule breaking in the absence of visible authority August 2012

Frontal cortex has a slow course of development – EF skills continue to develop into the mid-20’s Should be able to formulate a long-term goal and steps needed to accomplish the goal. Inhibit reckless and dangerous activity and understand how this impacts their overall long-term goal August 2012

What kinds of students may have EF deficits?
Autism Spectrum Disorders (EF deficits found to be more severe for ASD than ADHD) (Geurts et. al. 2004, Goldberg et. al, 2005, ADD/ADHD Tramautic Brain Injury patients Untreated Phenylketonuria (PKU) – infant metabolic disorder (Diamond et. al. 1997) Pre-maturity (Mulder et. al. 2009) August 2012

How do EF Skills impact students educationally?
Academic Impacts – Math & Literacy Social Impacts Behavioral Impacts Organization Impacts August 2012

EF deficits impact students academically….
Difficult to self-monitor comprehension while reading independently Difficulty monitoring the accuracy of their work Difficulty revising and editing one’s own written work Difficulty separating low relevance details from the main idea Working memory deficits can impact comprehension of longer texts Extreme difficulties planning written language assignments Inconsistent academic performance Difficulty getting started on work, frequently asks, “What do I do first?” August 2012

Impact on reading/writing specifically: Impact on math specifically:
Fluency – may skip whole words or lines of text without noticing Child remembers specific details from text, but not in an organized, sequential manner Written work may regularly omit small words (“the, is, a”) Strong reluctance to edit written work Impulsive guessing at unknown words based on the 1st letter Impact on math specifically: difficulty shifting between operations , sequencing steps and ignoring extraneous information in word problems Math work contains numerous “careless errors” May want to jump quickly to guessing at the answer without moving through the process to solve the problem. August 2012

EF deficits impact students socially….
Difficulty in conflict resolution with peers If students struggle with impulse control, peer rejection may be a long standing problem Difficulty explaining why he/she does things Can become over-whelmed with intense emotions (positive or negative) May forget what he/she wants to say in conversation Interrupts and cuts peers off in conversation August 2012

EF deficits impact students behaviorally….
Limited frustration tolerance for other people’s behavior, changes in routine, or cognitive tasks May become verbally or physically aggressive when angered Difficulty initiating work – student may “just sit there” when others have begun working. Work output may be brief – “That’s all I can do.” “I can’t think of anymore.” May easily “shut down” if individual help is not readily available Blurts out frequently in class August 2012

EF deficits impact students organizationally….
Difficulty planning long-term assignments and projects - difficulty planning incremental steps for progress Difficulty using an assignment notebook or planner Can tell time, but seems surprised by how much time has passed Completes assignments, but forgets to turn them in. Extreme disorganization of papers and materials August 2012

Assessing EF Skills August 2012

Formal Assessment Options (for “school-folk”)
Behavioral Rating Inventory of Executive Function – BRIEF (Gioia, Isquith, Retzlaff, & Espy, 2002) 86 items - Multiple Rating Forms (parent, teacher, and self-rating for ages 12+) 8 Clinical Scales: Inhibit Initiate Organization of Materials Shift Working Memory Monitor Emotional Control Plan/Organize Can purchase the whole kit for $250 at: August 2012

Formal Assessment Options (for “school-folk”)
MetaCOG - Metacognitive Awareness System (Meltzer et al ) 9-18 year olds Teacher and student rating scales TEACHER QUESTIONNARIRES: Teacher Perceptions of Student Effort Teacher Information Questionnaire STUDENT QUESTIONNAIRES: Motivation and Effort Survey Strategy Use Survey Metacognitive Awareness Questionnaire Can purchase the Questionnaires from: ($40) August 2012

In-Formal Assessment Options (for “school-folk”)
Parent, Teacher, Student Interviews Good Resource: Executive Skills Semi-Structured Interview – Teacher Version, Parent Version, & Student Version Found in the book: Dawson & Guare (2010). Executive Skills in Children and Adolescents: A Practical Guide to Assessment and Intervention. Guilford Press - August 2012

Teacher Questionnaire explores:
Independent Seat Work Organization of Materials Remembering Self-Control Long-Term Projects Problem Solving Student Questionnaire explores: Homework Long-Term Projects Studying for Tests Home Chores/Responsibilities Organization Leisure Time Questionnaires have a Summary component which yields a hierarchy of EF strengths and challenges. Has a nice planning guide for intervention as well Parent Questionnaire explores: Same as Teacher version – substituting Homework for Independent Seatwork questions August 2012

Parent, Teacher, Student Interviews Good Resource: Executive Function Semi-Structured Interview – Teacher Version, Parent Version, & Student Version Found in the book: Kaufman, Christopher. (2010). Executive Function in the Classroom: Practical Strategies for Improving Performance and Enhancing Skills for All Students. Brookes Publishing Shorter and less complicated that the Dawson and Guare interview. On this scale, respondents rate indicators in a 4 point scale Categories for respondents are: Goal Setting/Decision Making, Materials Organization, Attention/Task Initiation, Time Management, Working Memory, Impulse Control, Adaptability. August 2012

Educational Observations – areas to examine Independent Work Time Is he able to initiate his work on his own? Can he sustain work and effort? How does he acquire help? Does he have all of his materials? Does he seem to “run out of steam”? Are there obvious distracters for him? Transition Time Is he leaving & arriving on time? Does he seem emotionally comfortable and in control? Is he distracting others? Instruction Time Lecture or Look for attention signs Does he get in trouble for blurting out, interrupting or daydreaming? Does he take notes? Organization Locker Desk Planner Backpack Look at samples of pre-writing planning & brainstorming Observe natural classroom organization structures August 2012

Getting it into the Report
Social/Emotional/Behavioral section Provide a brief definition of EF skills and the relevance to the Educational Setting Example: “This evaluation also examines how <STUDENT> is able to apply “executive function” skills throughout his school day. Executive Function skills are those elements of cognition that allow <STUDENT> to self-regulate and self-direct throughout the school day. Domains of Executive Function skills especially relevant for <STUDENT> include skills related to: emotional control, organization of time and materials, ability to manage homework and independent work activities in the classroom, the ability to focus/attend, and the ability to problem solving independently. “ August 2012

Getting it into the Report
3 Sections of the write-up: Report on the BRIEF or MetaCOG, etc – any standardized tool if used Report on any Semi-Structured Interviews completed (ex: the Dawson/Guare, or Kaufman interview protocols) Parent Teacher Student Cite the book of the checklist you used in the report. Classroom Observation Input – use the 4 categories: Independent Work Skills, Transitions/Adaptability, Participation in Instruction, Organization Summarize EF strengths/areas of growth, and prioritize need areas August 2012

Strategies to Support EF Skills
August 2012

Factors to Consider EF is learned in day to day activities with real life problems EF is developed by modeling and supported practice Consider if YOU have adequate EF skills in order to coach someone with EF needs! Consider reframing accommodations & modifications for students as EQUALIZERS August 2012

Explaining EF to Kids Important for kids to understand WHAT they are working on! Different than working on reading, multiplication, or handwriting. Explain your “role” as a support teacher – frame it using the Multiple Intelligences model. August 2012

Explaining EF to Kids LEARNING STYLES
Multiple Intelligences Wheel (Gardner, 1983) Number Smarts Space Smarts People Smarts Body Smarts Nature Smarts Music Smarts Word Smarts “Interpersonal and Intrapersonal” Intelligences relate to EF skills (a.k.a. “People Smarts” and “Self-Smarts”) Use celebrities and public figures relevant to the student to exemplify various learning styles ME August 2012

More on Multiple Intelligences..
Source: Comics Camp Currier Art Center | Christa McAuliffe Technology Conference Workshop Website Location: August 2012

Call a spade a spade… August 2012

“Well, I am your….uh..uh.. EF Teacher EF Coach Social Smarts Teacher
Social Skills Teacher School Strategy Coach Other ideas? August 2012

Airplane Emergency Exit
Larry David: Airplane Emergency Exit Emotional Regulation? August 2012

Strategies to Support Emotional Control
The Zones of Regulation teach students about self-regulation and controlling difficult emotions by Leah Kuypers, M.A., Ed, OT/L. The “Zones of Regulation”, are described by the author as, “….. a systematic, cognitive behavior approach used to teach self-regulation by categorizing all the different ways we feel and states of alertness we experience into four concrete zones. The Zones curriculum provides strategies to teach students to become more aware of, and independent in, controlling their emotions and impulses, managing their sensory needs, and improving their ability to problem solve conflicts.” Weaves principals from the field of sensory integration, use of the 5 Point Scale (Dunn-Buron & Curtis, and the principles of social cognition as described by Michelle Garcia Winner, ( –$42 August 2012

Kuzma, 2/2010 - http://jillkuzma.wordpress.com

Self-Talk Scripts Kids are missing the internal dialogue scripts that we have with ourselves when we are frustrated, confused or upset. We want our “coach” words to go into their head as their own script. August 2012

Social Filter Water filter analogy - traps the harmful dirt and germs, so only the “good” stuff comes through the filter Social Filter - traps the harmful words, so only kind words come through Relate to “Don’t pop your thinking bubble!” Created by Jill D. Kuzma 2/09 Created by Jill D. Kuzma 10/07

“I’m an insensitive person!”
Dick Solomon: “I’m an insensitive person!” Social Sensitivity? August 2012

Created by Jill D. Kuzma 2/09
Social Filter Created by Jill D. Kuzma 2/09 Created by Jill D. Kuzma 10/07

Created by Jill D. Kuzma 2/09

What does the situation look like when your social filter is ON vs. OFF
Helps kids develop metacognitive skills to self-monitor their own behavior August 2012

Social Behavior Mapping (Michelle Garcia-Winner – “Expected” vs. “Unexpected” Social Behaviors Perspectives of other people around you Outcomes you experience in the situation How you feel about yourself August 2012

Children’s Literature for Emotional Control
The Busy Beaver Author/Illustrator: Nicholas Oldland Interest Level: Ages 3-7 From the Book Jacket: There once was a beaver who was so busy that he didn't always think things through. After finding himself on the wrong side of a falling tree one day, the beaver begins to see the error of his careless ways. OH, No, George! Author/Illustrator: Chris Haughton Interest Level: Ages 4 and Up From the Book Jacket: George is a dog with all the best intentions. But when George spies a delicious cake sitting on the kitchen table, his resolve starts to waver. You see, George loves cake...What will George do? August 2012

Children’s Literature for Emotional Control
Author: Gail Silver Interest Level: Ages 4-9 From the Book Jacket: "Who are you?" asked Anh. "And how did you get into my room?" "I'm your anger," said the creature. "You brought me here." Ahn's Anger can help children learn to acknowledge and understand the causes of their own strong emotions, and ultimately feel safe expressing themselves and accepting accountability for their actions when appropriate. Author: Julia Cook Interest Level: Ages 4-8 About This Book:. Louis, a self-taught space expert is delighted to learn that his teacher has sent him to the principal's office to attend personal space camp. Louis soon discovers that he has much to learn about personal space right here on earth. Personal Space Camp addresses the complex issue of respect for another person's physical boundaries. Author: David Ezra Stein Interest Level: Ages 4-8 From the Book Jacket: It's bedtime for the little red chicken, and Papa is going to read her a story. "You're not going to interrupt the story tonight, are you?" asks Papa. "Oh no, Papa. I'll be good," says the little red chicken. But she just can't help herself! August 2012

Strategies to Support Focus & Attention Skills
Music, Color, Media, Novelty gets past the brain's attention filter to promote and sustain attention Involuntary attention filter in the low brainstem (reticular activating system-RAS). It gives priority to novel, unusual, curious sensory information. August 2012

“Types of Distracters” August 2012

Distracter Blasters! August 2012

“Coming Attractions”… You can reveal new parts of a covered poster, photograph or other curiosity-building symbolic representation every few days leading up to the unit as students enjoy making and changing their predictions as they interpret new clues Increase the likelihood that their intake filters will select the sensory input of coming unit. August 2012

Key Word Listening Key die cut – or Xerox cut out – teach kids to write key words while listening on the key as a visual cue to support sustained attention and organization later for independent work My Jobs at Work Time Worksheet 3 Ideas- How To Book Box August 2012

Science: Electricity Math: Angles A ___U ___ E PR__ __ __ __
L__ __ __ than __ __ degrees A __ O ___ Draw one: NEU__R__N August 2012

Teach IGNORING..the right way… We tell kids to “ignore” all the time (ignore peers bothering them, ignore environmental distractions, etc) Often we ask kids who are the MOST reactive and distractible to ignore! Need to “define” ignore – may be an abstract term for kids who are literal. Teach when to ignore, how to ignore, when NOT to ignore, etc. August 2012

You have a super brain power that you can use anytime!
From the PPT for kids about IGNORING Your Super Brain Power! You have a super brain power that you can use anytime!

Sometimes kids might do things to bother or annoy you.
From the PPT for kids about IGNORING Sometimes kids might do things to bother or annoy you. Jill D Kuzma, M.A., CCC-SLP,

From the PPT for kids about IGNORING
Kids might say or do things that distract you. These distractions make it hard for you to FOCUS and do your job at school. Jill D Kuzma, M.A., CCC-SLP,

These are called DISTRACTIONS. Distractions are people, things or sounds that take our attention away from what is important. Jill D Kuzma, M.A., CCC-SLP,

But, the good thing is… You have a super brain power! You can IGNORE these distractions! Jill D Kuzma, M.A., CCC-SLP,

Ignoring: Pretending you cannot see or hear what someone else is doing
From the PPT for kids about IGNORING Ignoring: Pretending you cannot see or hear what someone else is doing Jill D Kuzma, M.A., CCC-SLP,

Why should we ignore kids who are distracting us?
From the PPT for kids about IGNORING Why should we ignore kids who are distracting us? Keeps you out of trouble yourself Helps you focus and learn We make good choices when we ignore distractions. Jill D Kuzma, M.A., CCC-SLP,

How to Ignore: Do not look at the person Do not listen to the person
From the PPT for kids about IGNORING How to Ignore: Do not look at the person Do not listen to the person Do not talk to the person Jill D Kuzma, M.A., CCC-SLP,

Jill D Kuzma, M.A., CCC-SLP, http://jillkuzma.wordpress.com
Practicing Ignoring Role Play ignoring in various contexts, varying lengths of time: distracting sights, sounds, distracting locations Reinforce with tally marks, legos, sticks, etc. using an interval schedule at first. Move to “regular” activities, but continue to reinforce at certain times for “good ignoring” Move to having kids monitor each other and themselves. Jill D Kuzma, M.A., CCC-SLP,

Highlight math operation signs Proofread out-loud and backwards
Teach SELF-MONITORING skills for students that have FOCUS and ATTENTION issues: Highlight math operation signs Proofread out-loud and backwards Highlight key words of directions (not, but, all) August 2012

Children’s Literature for Attention/Focus
Good website: Audio stories, or PDF copies August 2012

Screenshot from the website: http://freestoriesforkids.com
August 2012

Author: S.J. Fore Interest Level: Ages 4-8 Description: A quiet evening, a cozy couch, and a favorite book - what more could a little boy need for a pleasant evening at home. Until...how can anyone enjoy his book when there's an energetic, imaginative tiger behind the couch, just begging for attention? Author: Howard Binkow Interest Level: Preschool - Age 7 About This Book: Meet Howard B. Wigglebottom, a curious rabbit who just doesn't listen! This book is designed to help young children improve their listening skills and pay attention.. Author: Roger Hargreaves From the Mr. Men & Little Miss series August 2012

Author: Julia Cook Interest Level: Ages 4-8 From the Book Jacket: Being a verb is hard...especially for Louis, who can't seem to control himself when he gets the urge to move at the wrong time and situation. A positive resource for anyone dealing with ADHD or challenged by someone who has ADHD. Author: Julia Cook Interest Level K-4 About the book: RJ has had a rough day... Everything seems to go wrong. With his mother's help, RJ learns that his problems happen because he doesn't listen or pay attention to directions from her, his school principal, teachers, or even his friends. Author: Christianne Jones Illustrated by Richard Watson Interest Level: K-3 About This Book: Lacey Walker loves to talk. She talks all day, and sometimes all night. But when she loses her voice, Lacey learns the importance of listening. August 2012

Strategies to Support Organization Skills
VISUAL CUES Photo of desk and locker to show how it should be organized August 2012

Velcro Visuals for Desk Sorting
Fading Your Support Start by emptying the entire desk each time 1st time – you hand each item to child, asking them to place in a pile 2nd time – child pulls out each item while you supervise 100% and place in piles 3rd time – you give child visuals, they sort while you watch at the desk 4th time – give child visuals – tell them to start for 5 min and then check on them to finish 5th time – leave visuals on child’s desk with note and then follow up August 2012

ERROR CHECKLISTS Steps to check off before turning in a test, finishing writing an essay, completing a math problem, etc. August 2012

HOMEWORK Planning Sheets Completed at the end of the day with staff member to plan for homework completion in the evening. Allows for parent/student/teacher communication triangle. Can tie into data collection as well August 2012

Homework Planning Sheet Example:
August 2012

TEACH CALENDAR CHECKING Many kids with EF deficits need this taught explicitly as a skill & routine Not just checking the classroom’s schedule on the board Help them understand WHOLE to PART (Month at a glance – Week – Day) Explore which “view” works better for them. Highlight CHANGES in the calendar Active engagement in creating a calendar system that works for THEM. Great website for calendar and planner templates: August 2012

Technology to Support Organization Skills
App: Kids Calendar (by ConSept) $2.99 August 2012

App: 4KidCal (by 4KidCal LLC) $1.99 Can view as a month or day – allows for audio recording reminders! August 2012

App: Homework (by Mango, LLC) $4.99 August 2012

App: Homework Tracker w/Reminders (by Alex Rastorgouev), $1.99 August 2012

Random “Pinterest Pins” to Support Organization Skills
“HOMEWORK POSTERS” Source: from the blog, Peonies and Poppyseeds. “CHAIR BACKPACKS” Source: from the blog, Confessions of a Nerdy Teacher. August 2012

Suffers from Short-Term Memory Loss
Dory: Suffers from Short-Term Memory Loss Working Memory? August 2012

When supporting PLANNING a task – engage both the VERBAL and NON-VERBAL working memory. Example:
5th grade Assignment: “Over the next 2 weeks you will put together a project and presentation about a natural disaster, such as a tsunami, tornado, earthquake, etc. You need to choose a disaster, research a specific instance where this occurred and create a PowerPoint presentation of at least 6 slides about the disaster. SELF-TALK….”Well, we learned how to do a PowerPoint in 4th grade for our All About Me projects. It wasn’t too hard to do. I read a book about Tornados a while age. Wait…I think my mom said a tornado hit her house when she was a kid. Maybe I will do tornados. I gotta talk to my mom and find that book I read….. August 2012

A Working Memory AND a Planning Strategy!
If-Then Planning Bubbles IF I imagine this as the end goal… THEN, I have need to do these steps…. August 2012

FIRST….engage the NON-VERBAL working memory....
Create a mental picture: For assignments: What does this final product look like? For organization: What should my desk or locker looks like when it is clean? For social situations: How do I want kids to treat me? August 2012

THEN….engage the VERBAL working memory....
Create a the verbal Self-Talk What materials or things do I need to get this done? How much time do I have? Who needs to help me? What steps do I take? What do I do first? August 2012

Well, I need to plan an experiment with the candles…I should figure out my hypothesis first and what things I need for the experiment, then I need to make some kind of a chart or graph to show what happened… August 2012

I want to join a 4 square game…lets see
I want to join a 4 square game…lets see..first I need to find kids playing already, then I need to stand in the line to wait for someone to get “out”…I should ask Mrs. Kuzma about the rules again… August 2012

Sometimes, WE need to provide the Self-Talk Script!
Do this through a LOT of modeling yourself! Use a “If-Then Bubble Planning sheet” – with students for longer term assignments, social situations, etc. Cut out the image bubble (thought bubble) as a visual reminder of the goal they are working toward Cut out the Self-Talk bubble (talking bubble) with a scripted phrase or verbal cue relating to the goal. August 2012

Strategies to Support Working Memory Skills
Backward Chaining Breaking down the steps of a task and teaching them in reverse order Gives the child an experience of success and completion with every attempt. Instead of the child starting at the beginning and getting lost somewhere through, with the adult having to complete the task, the adult does all but the last step and lets the child complete the work. Then the adult fades back, doing less and less while the child does more and more, always ending with the child performing the final step. August 2012

When you might use Backward Chaining:
When completion of the task provides natural reinforcement for the student When "escaping” from instruction would motivate the student When the learner has mastered less than half of the steps in the task chain OR when the learner is close to already having acquired the steps near the end of the chain When the learners are less patient or less inclined to be cooperative August 2012

Examples: Steps to do a long division algorithms
You might use backward chaining to teach: Steps to do a long division algorithms The steps of an arrival or dismissal routine Steps involved in a functional routine such as making cookies, making your bed, cleaning our your desk, getting snow gear on for outside recess Great article online to explain how to set this up: August 2012

Strategies to Support Working Memory Skills
Teach “Holding” Codes “Holding Codes” are a way to code, or make pictures, to remember thoughts when reading, watching something that you need to be quiet during, or during a group sharing time. August 2012

Examples: Kids each have a cue card during a “lesson time” – they point to the code, THEN raise their hand Use as a note-taking sheet during a teacher “lecture” Notes about: ___________ Use to monitor thoughts while reading text August 2012

Michael Scott: “I burned my foot!” Planning Skills?
Planning Skills? August 2012

Strategies to Support Planning Skills
Rubrics - blueprints to guide EF skills Behavior, Attitude, Motivation and Effort Rubrics – for kids to self-monitor themselves for independent work time Group Work Rubrics – effort, attitude, etc. For kids to self-monitor Use student-teacher conference time to plan and go over rubrics – then graphically track incremental progress – like video game levels August 2012

THINK ALOUDS “Hmm. What do I need to do before I…?” “I will write that down here” “Wow! That didn’t go as I expected! What are my options now?” “I’m too upset to think clearly. I need to take a walk.” “I wonder who I can ask for help about…?” “We want to go on vacation in two months. I’m going to start planning now.” August 2012

The SWEEP of TIME Use cut-outs, dry-erase markers, etc to show the sweep of time for longer time blocks such as literacy, math, etc.) August 2012

Could use to show the passage of time for a preferred activity like a computer break – helps kids understand how time “feels” Use to show the time frame for multiple jobs or activities – this is a morning arrival picture August 2012

Use visual cues on the clock to show the START time, the half-way checkpoint time, and the STOP time. GREAT PRODUCT: Tracknets – magnets with these cue phrases available for purchase at functiontherapy.com ($24.99) August 2012

Technology to Support Planning Skills
Apps: Think Tree (mindmapping) (By Yeong Nam Chae), .99 August 2012

Apps: Popplet (by Notion), $4.99 August 2012

Apps: Mindjet for iPad (By Mindjet LLC) – currently free, was $8.99 August 2012

Service Model Ideas for Supporting EF Skills
Where to start with an individual student(s) without becoming over-whelmed. Broader ideas for more programmatic or systemic additions to support EF skills as a SpeEd dept. August 2012

Where would I even START??!!
You probably have many kids you are thinking about right now…perhaps they have EF needs in all of these areas? Where would I even START??!! August 2012

Start SMALL! Pick 1-5 students you feel struggle the MOST with EF skills (Clue: Look for kids with heavy SEB goals/obj that you feel are draining you) Think about which specific EF area they seem to struggle the most in. (Refer to Slide 114 again) Which specific element of the EF domain do they seem to struggle the most with? Can use some of the assessment tools, or even just start with your background knowledge of the student and other assessment data gathered previously. How can you gather some baseline data? August 2012

Focus & Attention Skills
Emotional Control Impulse control Adaptability Cognitive Flexibility Inhibition & Initiation Working Memory Verbal working memory Non-verbal working memory Planning Skills Self-checking/monitoring Prioritizing, planning increments Problem Solving Organization Materials, space (desks-lockers) Ideas Time Management Focus & Attention Skills Selecting the attention target/main topic Ignoring Distractions Activating & initiating work Task Persistence Executive Function Categories August 2012

Jamie 4th grader Example: 1st Priority 2nd Priority 3rd Priority
Jamie’s IEP is under OHD – he has a Dx of ADHD. He’s been on an IEP since kindergarten. His re-eval was last year and the team did not explicitly assess EF skills, but these need areas are the “gut instinct” of the team that has been working with Jamie. His IEP is due in 4 months – the team plans to add some more informal assessment tools in his new IEP PLAAFP, but would like to get started on some EF support now. Jamie 4th grader Struggles with Organization Tracking Assignments Returning homework Struggles with Planning Skills Planning long-term assignments Knowing when he needs help Bringing materials to class Example: 1st Priority 2nd Priority 3rd Priority August 2012

EF Informal Baseline Data for Jamie
1st Priority Skill: Independent organization and tracking of desk/locker materials needed for learning (Assignment Notebook, Take-Home Folder, books, etc.) Fill out Assignment Notebook Tally +/- for 5 days if completes assignment notebook without prompting Return Homework to School Selected Math as the measurement area – tally +/- if homework was returned completed Has necessary materials for class Tally +/- for math, social studies, and writing, across 5 days August 2012

Jamie’s Baseline Data:
Completed Assignment notebook independently – writing in all assignments accurately – for 1 out of 5 days. Brought completed Math home work back to school for 2 of the 5 days. Brought all necessary materials to 3 identified classes (social studies, writing, and math) – for 6 of the 15 class periods (5 day data period). (Forgot materials for math for 5/5 class period, for social studies for 3/5 periods, and writing 1/5 periods) INTERVENTIONS SHOULD TARGET: MATH (at this point in time – start small!) Increase independence in writing in the Assignment notebook Increase the frequency of returning math homework Increase Jamie’s independence in bringing all materials needed for math (calculator, pencil, graph paper, notebook, & text) August 2012

Intervention Plan & Timeline for Jamie:
Assignment Notebook: Math Post-it note from teacher to near-point copy assignment himself & teacher signature 10/7 - 10/18 10/21 – 10/25 – Fade post-it note, to verbal cue & teacher signature 10/28 – 11/1 – Fade verbal cue – data collection on independence Return Math Homework Homework Planning Sheet w/Resource Teacher daily 3:15- 3:30 10/7 – 10/18 10/21 – 10/25: Jamie complete homework planning sheet on his own, in resource room – check from resource teacher before going home 10/28 – 11/1 – Provide Jamie with 5 copies of Homework Planning Sheet. Remain in classroom at end of day. Data collection on returning math homework Bring materials to math class Create visual cue card with Jamie – place inside locker door. Check in with him on 10/10 & 10/17 to remind him to use it Consult with math teacher Data collection this week 10/28 – 11/1 August 2012

Goals for a “Mini EF” Program at your site
Why teach EF skills? Kids understand their own learning style Increase independence Increase self-confidence Promote motivation & hard work Teach kids HOW to learn August 2012

Importance of Student Goal Setting and Self-Monitoring
Goals for the Trimester, the Month, the Week, the Day Student is engaged in setting goals Remember – STAY SMALL – teach ONE thing at a time to avoid discouragement and frustration for the student. August 2012

Goal Monitoring: “Positive Everyday Routines” (Ylvisaker & Feeney, 1998) GOAL – PLAN – DO - REVIEW
What do I want to accomplish? 2. Plan How will I accomplish my goal? 3. Do Try my plan 4. Review How did it go? August 2012

Example: 1. Goal I want to bring my planner to school everyday 2. Plan I plan to put my planner in front of the front door when I go to bed 3. Do I will do my plan for 5 days and keep track of how it went. 4. Review I only remembered my planner 2 out of 5 days with this plan. I need to revise my plan. New PLAN New Plan: put my planner in my backpack after I brush my teeth. Hang backpack on bedroom doorknob. August 2012

August 2012

Create a Strategy Wall Similar to a WORD wall, or CAFÉ literacy headers, etc. Our Strategy Wall Emotional Control Focusing Working Memory Organization Planning - Zones of Regulation - SBM - Social Filter Analysis - Holding Codes - Backward Chaining - - Calendar checking - Desk sort cards - MindMap - Homework Planning Sheet - Sweep of Time clock - Mental Picture Self-Talk bubbles GPDR - Focus Fidgets - Ignore Power - Key Word Listening August 2012

Arrival Time Ideas Plan for Morning Coaching time when kids arrive - in your Resource room, or office – 35 min group time (ex: 9:10 – 9:45) Maybe even a locker, lunch count and attendance in your resource room if student gets easily overwhelmed Maybe a group of 3-6 kids who have the most need for Morning Coaching to get the day started off right. Stations: 2 -3 “stations” lasting 5 minutes or so customized for the needs of each child. (see next slide) 15 min. Greeting: at the door with Individual schedule strips 5 min. Whole Group: mini-lesson or Calendar checking 10 min. Send-Off: Students each do a Goal Review & send them off with encouragement 5 min. August 2012

Arrival Time Station Ideas
Schedule 3 stations to run 5 minutes each, or two stations to run 7 minutes each Have a bell or audio signal to transition to the next station Try to keep talking to a minimum – this is a time for students to “ready” themselves for the day Tasks should not be frustrating or require adult assistance Sensory activity (swinging, fine motor task) academic “morning sheet” to reinforce skills iPad app to reinforce skills such as practice spelling words, math facts, etc. Mazes, Sudoku, Rush Hour, color by number Read a Social Story a child has been working on Watch a video model for a skill a child is working on Listen to a book on tape Water color painting Handwriting practice August 2012

Whole Group Time to explicitly teach Calendar Checking skills
Each student has a Calendar book, planner, etc – customized for them Mini-Lessons – (5 min) Add strategies to your Strategy Wall - review strategies used or learned Address any upcoming Changes for students at various grade levels Encouraging quote of the day Read aloud story to reinforce a skill August 2012

Mid-Day Thoughts Schedule service times during recess, lunch, the AM arrival time, etc. Study Hall time? Push-in service could be scheduled during science/social studies or “specialist” classes (PE, music, art, etc.) kinds of classes – often they are less structured with more peer interactions August 2012

at the door with Individual schedule strips
Departure Time Ideas Morning crew could come back together for final 15 minutes of the day. Follow the same routine as AM group Greeting: at the door with Individual schedule strips 2 min Station: 1 “station” job lasting 5 minutes or so customized for the needs of each child. (see next slide) 1o min. Whole Group: Compliments Best Moments Group cheer 5 min. August 2012

Departure Time Station Ideas
Assignment Notebook/Planner - checking with the teacher Complete the Homework Planning Sheet for students using this intervention Fill out any Behavior Charts, Goal sheets, or Home-School Communication sheets Clean out/Organize folders Review a social story/video model August 2012

Web Resources for EF Sarah Ward, M.S. CCC-SLP & Kristen Jacobsen, M.S., CCC-SLP Article series by Phillip David Zelazo, PhD Learning To Learn – Dr. Erica Warren: Michelle Garcia Winner’s website: August 2012

Web Resources for EF Willis, J.A. (2011). Teachers are the Caretakers of Students’ Future Potentials: Their Executive Functions. Edutopia Staff Five-Part Series for Summer Professional Development Part 1: Where and How the Brain Thinks: Part 2: Strategies for Teaching Executive Functions Part 3: Writing is Neuro-logical Nourishment for the Executive Functions Part 4: Creativity and the Arts to Get Learning to the Thinking Brain Part 5: Nurture Creativity to For the Prefrontal Cortex Triad: Executive Functions, Long-Term Memory, and Emotional Self-Control – website for Judy Willis, M.D., M.Ed – Dr. Willis is a neurologist AND classroom teacher. Her website features the insights and publications about brain based learning. August 2012

Web Resources for EF - Dr. Lynn Meltzer’s website, The Research Institute for Learning and Development Coaching the ADHD Student: A Guide for people who work with children with ADHD to help enhance their organizational, study and time-management skills. Dawson, Peg & Guare, Richard. (2000). Multi-Health Systems, Inc. August 2012

References Barkley, R.A. (2010). Taking Charge of ADHD. Guilford Publications, New York. Barkley, R.A. (2011). The Important Role of Executive Functioning and Self-Regulation in ADHD. Article based on the book, Executive Function and Regulation: Extended Phenotype, Synthesis, and Clinical Implications. (2012). Guildford Publications, New York. Best, J. R., & Miller, P. H. (2010). A Developmental Perspective on Executive Function. Child Development, 81(6), Brandon, Bill (2003). The Power of Backward Chaining. Learning Solutions Magazine - Brown, Thomas E. (2008). Executive: Describing Six Aspects of a Complex Syndrome. CHADD, February 2008, pg Dawson, P & Guare, R. (2009). Smart but Scattered. The Guilford Press. Dawson, P. & Guare, R. (2004). Executive Skills in Children and Adolescents: A Practical Guide to Assessment and Intervention. The Guilford Press. Diamond, A., Prevor, M., Callender, G., & Druin, D. (1997). Prefrontal cortex cognitive deficits in children treated early and continuously for PKU Monographs of the Society for Research in Child Development, 62. Fisher, N., & Happé, F. (2005). A training study of theory of mind and executive function in children with autistic spectrum disorders. Journal of Autism and Developmental Disorders, 35(6), August 2012

References Gardner, Howard. (1983). Frames of mind: The theory of Multiple Intelligences. New York: Basic Books. Geurts, H., Verte´, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. (2004). How specific are executive functioning deficits in attention deficit hyperactivity disorders and autism? Journal of Child Psychology and Psychiatry and Allied Disciplines, 45, 836–854. Goldberg, M., Mostofsky, S., Cutting, L., Mahone, E., Astor, B., Denckla, M., et al. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35, 279–293. Happe´, F., Hughes, C., Booth, R., & Charlton, R. (2006). Executive dysfunction in autism spectrum disorders and attention deficit/hyperactivity disorder: Developmental profiles [Special issue on Asperger’s syndrome]. Brain and Cognition, 61, 25–39. Kaufman, Christopher. (2010). Executive Function in the Classroom: Practical Strategies for Improving Performance and Enhancing Skills for All Students. Brookes Publishing Luciana, M. (2003). Practitioner review: Computerized assessment of neuropsychological function in children: Clinical and research applications of the Cambridge Neuropsychological Testing Automated Battery (CANTAB). Journal of Child Psychology and Psychiatry, 45, 649–663. August 2012

References Meltzer, Lynn (2010). Promoting Executive Function in the Classroom. Guilford Publications, Moraine, Paula. (2012). Helping Students Take Control of Executive Functions: The Attention Fix. Jessica Kingsley Publishers. Mulder, H., Pitchford, N., Hagger, M., & Marlow, N. (2009). Development of executive function and attention in preterm children: A systematic review. Developmental Neuropsychology, 34, 393–421. Ozonoff, S., South, M., & Provencal, S. (2007). Executive functions in autism: Theory and practice. In J. M. Pérez, Gonzalez, R M., Comi, M. L., & Nieto, C. (Eds). New developments in autism: The future is today (pp ). London, England: Jessica Kingsley. Ylvisaker & Feeney (1998). Collaborative Brain Injury Intervention: Positive Everyday Routines. Willis, J.A Want Children to “Pay Attention”? Make Their Brains Curious! Force-feeding won’t work even on a hungry brain. Psychology Today Online. Willis, J.W. (Fall 2010) Rubrics as a Doorway to Achievable Challenge. New Horizons for Learning, Journal of Graduate School of Education, Johns Hopkins University. Fall Winner, Michelle Garcia (2007). Social Behavior Mapping. Think Social Publications. Zelazo, P. et al. (2010) - 6 Part Series on Executive Function August 2012

Jill D. Kuzma, M.A., CCC-SLP Speech-Language Pathologist

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